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UCLA Health
Los Angeles
Description Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. In this key position, you will be the primary point of contact for receiving and resolving member denials. You will review de
Job Source: UCLA HealthVivo HealthStaff
Burbank, CA, United States
Job Description: Clinical Supervisor, UM Denial ComplianceLocation: Los Angeles Metropolitan AreaPosition Type: Hybrid (85% remote, 15% onsite in Burbank, CA)Company: Vivo HealthStaffOverview:Vivo HealthStaff is seeking a Clinical Supervisor for UM Denial Compliance. This role is essential in ensuring a high-quality, efficient, and compliant denial
Job Source: Vivo HealthStaffUCLA Health
Los Angeles
Description Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. You will play a key part in promoting high-quality, cost-effective medical care by applying clinical acumen and applicable po
Job Source: UCLA Health360 Behavioral Health
Los Angeles, CA, United States
Job Category : Z&S Management Chatsworth Support Center Requisition Number : UTILI002763 Apply now Posted : April 26, 2024 Full-Time Locations Showing 1 location Van Nuys, CA 91406, USA Description Who are we? At 360 Behavioral Health, we take pride in our long-standing commitment to providing exceptional care for individuals impacted b
Job Source: 360 Behavioral Health360 Behavioral Health
Los Angeles, CA, United States
Utilization Management Coordinator- Temporary Assignment Job Category : Z&S Management Chatsworth Support Center Requisition Number : UTILI002753 Apply now Posted : April 23, 2024 Full-Time Locations Showing 1 location Van Nuys, CA 91406, USA Description Temporary Assignment- 4 months Who are we? At 360 Behavioral Health, we take p
Job Source: 360 Behavioral HealthUniversity of California
Los Angeles, CA, United States
Description Provide key clinical support within a world-class health organization. Help ensure the delivery of exceptional, compassionate, and appropriate patient care. Take your professional expertise to the next level. You can do all this and more at UCLA Health. Under the direction and supervision of the RN Assistant Director, the Case Managemen
Job Source: University of CaliforniaUCLA Health
Los Angeles
Description Take on an important leadership role within an award-winning health system. Help improve patient experiences and operational efficiency as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA Health. As a key leader within our Medicare Advantage team, you will be resp
Job Source: UCLA HealthWelbeHealth
Los Angeles
At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, functioning as both a care provider and care plan to those individuals we serve. Our Health Plan Services team plays a critical role in our participant’s journey and our Utilization Management team
Job Source: WelbeHealthLos Angeles, CA, United States
Description Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health.
In this key position, you will be the primary point of contact for receiving and resolving member denials. You will review denials for accuracy, confirming the receipt of necessary documentation to support the denial and ensuring compliance with all contractual obligations and state and federal laws/regulations. You will extrapolate and summarize essential information for the UM Manager and Medical Director and regularly meet with them for clinical guidance in resolving cases. You will also document appeals in the tracking system and maintain relevant statistical data.
Salary Range: $22.03 - $43.68 Hourly Qualifications We're seeking a results-driven, quality-focused, self-motivated team player with:
* High school diploma, GED or equivalent
* Three or more years of managed care experience (e.g., MSO, IPA, or health plan)
* In-depth knowledge of medical terminology
* Understanding of the HMO referral process, eligibility verification, and health plan benefit interpretation
* Strong communication, interpersonal, organizational, and multi-tasking skills
* Exceptional critical thinking, analytical, and problem-solving abilities
* Proven execution and follow-up skills
* Computer proficiency with Microsoft Office
* Ability to cope well with ambiguity and stressful situations
* Ability to maintain confidentiality of patient and business records
* Ability to thrive within a complex academic medical center
* Ability to develop, implement, and evaluate methods and systems to improve efficiency
* Ability to lead and facilitate cross-functional workgroups and other meetings
* Expertise in achieving compliance with regulatory requirements
* Strong service orientation
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California, as well as the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
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Email Alert for Utilization Management Denial Coordinator jobs in Los Angeles, CA, United States
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